PATIENT ADMINISTRATION SYSTEM BUSINESS CONTINUITY PLAN V1.2

PATIENT ADMINISTRATION SYSTEM
BUSINESS CONTINUITY PLAN
V1.2
1. Introduction 1.1.
Following a major incident – the Senior Management Team will need to meet at
the earliest opportunity and consider this plan and prioritise the order in which
it will meet its commitments.
1.2.
Failure to deliver the Trust wide Patient Administration System could have a
detrimental effect on patient care and patient safety.
1.3.
Business Continuity Management (as defined by the Business Continuity Institute
2001) is:
“A holistic management process that identifies potential impacts that threaten an
organisation and provides a framework for building resilience with the capability for
an effective response that safeguards the interests of its key stakeholders,
reputation, brand and value-creating activities.”
Business Continuity Management is concerned with managing risk to ensure that, at
all times, the Trust can continue operating to, at least, a pre-determined level, in the
event of a major disruption. These risks can be classed as external – such as a
power failures, severe weather or internal, such as systems failures or loss of key
staff.
1.4.
The Trust has a responsibility under the Civil Contingencies Act 2004 as a Category
one responder. This means that the Trust is required to take up civil protection duties
and be able to perform its functions so far as necessary or desirable to respond to an
emergency. Part of this is to produce Business Continuity Plans.
1.5.
The Trust has approved a Business Continuity Planning Policy (see document library
for more information) and it is a requirement of that Policy that every department
produces Business Continuity Plans at local level that will relate to the services
provided.
2. Trust wide Patient Administration System – Business Continuity Plan
2.1.
In developing a Business Continuity Plan for the Trust – the Patient Administration
System is considered to be a critical organisational function.
There are many aspects to the Patient Administration System and each area that
uses PAS will need to consider what its functions are, so that it may be able to
foresee how it may have to professionally react to an emerging situation.
2.2.
Currently, any equipment or system which is the subject of malfunction or failure and
which cannot be resolved locally by the Team is reported to the CITS Help Desk.
2.4.
CITS will contact the relevant IT personnel with responsibility for the system or
equipment. IT personnel will then manage the situation until such time as the system
or equipment has been restored or replaced.
2 Patient Administration System
Business Continuity Plan
2.5.
In the event of the loss of a server and therefore potentially the loss of access to the
Patient Administration System (all of which are necessary requirements to ensure the
continuation of service), CITS will be responsible for switching applications affected
by the loss of a server onto another server to enable work to be progressed.
3. Risk Assessment
3.1
All activities within the service need to be risk assessed in order to determine the
order of reactivation. The risk assessment can be found incorporated into the
Action Plan
4. Scope of the Business Continuity Plan
4.1.
This BCP covers the loss of severs and other equipment necessary for the
continuation of service. Equipment including PC’s, photocopiers, scanners,
furniture and paper files and documents not kept in fire-proof cupboards
It therefore seeks to plan for a worst case scenario. In particular, the plan aims
to:
4.1.1. Identify the Senior Manager responsible for the initiation of the contingency plan
following the loss of service or location.
4.1.2. Ensure that all staff are accounted for and are advised of the situation.
4.1.3. Ensure that the Managers are aware of any individual roles and responsibilities
which they may have been given as a result of the loss of service or location.
4.1.4. Ensure that all staff are aware of the contingency arrangements as a result of the
loss of service or location.
4.1.5. Ensure that the organisation becomes operational as soon as possible at another
location following the loss of location.
4.1.6. The loss of the Patient Administration System would have a significant impact on
the Trust due to lack of information regarding its patients and records
whereabouts, both for inpatient and outpatient activity and the feed into all the
other systems that PAS interfaces with. There would also be an impact upon the
Referrals Management Service as they would be unable to make, agree and
book appointments (particular concern would be around the cancer referrals).
The impact would be specifically around the safety of patients in the event of a
fire and delivery of care without the benefit of the patient record, although this
would extend to potential loss of income with receptionists unable to record the
outcome of an attendance.
5. Initial Response
5.1.
It is the responsibility of the Information Asset Owner first contacted to ensure
that the remainder of the service team and Trust are informed.
5.2.
All members of the Senior Management Team will meet as soon as possible to
make a full appraisal of the situation.
3 Patient Administration System
Business Continuity Plan
5.3.
Information Asset Owner to add the loss of service to the Trust’s Incident
reporting system, Datix.
6. Manual Processes to Implement
6.1
Health Records Service
Health Records Library
This service will not be able to access pulling lists to retrieve records, so the only
records that the health records libraries will be able to retrieve will be those
needed in an emergency and this will need a hospital number which will be
available through the Maxims system. If Maxims is not available and the hospital
number is not known then records cannot be located in the library. If the number
is known the staff will check to see if the records are on file in the main libraries, if
they are not then there is an assumption that they are out in the organisation
somewhere and are not available.
Routine pulling can continue working from lists already waiting to be dealt with.
All records moved out of the department must be manually recorded using the
template at Appendix A
All records that continue to be returned to the department must be manually
recorded before filing.
Clinic Preparation
This service can continue to work from lists already waiting to be dealt with, but
all records must be manually recorded using the template at Appendix A before
sending out of the department.
Once PAS has been restored a small team of staff to be identified to input the
data retrospectively ensuring the sequence of date events on the tracking
system.
Disclosure Office
The staff in Disclosure can continue processing requests for duties that do not
require PAS, for example photocopying, retrieving notes if they are on file,
marking up and collating for sending out. Work that is dependent upon PAS
being available can be put to one side until it is available and then enter the
information.
6.2
Outpatient Booking Services
The Outpatient Booking Team will not be able to book appointments whilst PAS
is unavailable.
They can continue to take telephone enquiries recording information on the form
at Appendix B.
Other duties to consider during downtime would be to ensure all filing is up to
date
4 Patient Administration System
Business Continuity Plan
Once PAS has been restored staff will be expected to input the data
retrospectively ensuring chronology is maintained throughout.
Reception Services
Reception staff will be expected to keep a manual record of patients who have
attended their outpatient appointment and those that did not attend by recording
such information on their clinic list and a combination of manual data capture
form (Appendix C).
Reception staff to update PAS in chronological order once PAS is available
again. Reception staff will also be expected to retain outcome forms for
retrospective data entry once PAS becomes available. All telephone enquiries
will be captured and recorded o the manual data capture sheet.
Reception staff will have attendance lists printed for the next session’s outpatient
clinics and can continue to book patients in. Patients may bring their letter with
them which may assist staff in finding the patient on the lists. Outcome forms are
to be kept by the Reception staff until PAS is available again.
Once PAS has been restored staff will be expected to input the data
retrospectively ensuring chronology is maintained throughout.
Should PAS not be available for a considerable amount of time the Outpatient
Waiting List Manager will identify a team of staff to focus on retrospective data
entry.
Under no circumstances should verbal appointments be given out. When PAS
becomes available again then appointments should be made, letters generated
and sent to the patients.
The staff in Outpatient Services must also cross reference Section One of the
Information Services Business Continuity Plan at Appendix H.
6.3
Private Patients
The private patient office will be expected to keep a manual record of all patient
contact whilst PAS is unavailable. Appointment details for private patients are
also maintained on a Register of Private Appointments and this data will remain
accessible whilst PAS is unavailable. Appointments to see private patients are
recorded on personal electronic diaries via Groupwise so the private patient office
will continue to meet patients for their appointments, receipt of payment and
general advice and support. Any patient cancellations received by telephone or
email to be communicated to the relevant department as soon as possible and a
manual record maintained until such time as PAS is available again. This is
contained at Appendix D.
In response to telephone enquiries from potential private patients wishing to
make arrangements for a private appointment explain to the caller that the main
IT system is not currently available and that they will be telephoned back in x
hours to make the necessary arrangements. Information can continue to be
provided on price and expected wait and appointment times. Patient details to be
captured using Appendix D.
5 Patient Administration System
Business Continuity Plan
6.4
Inpatient Activity
Once PAS is unavailable SwiftPlus will also be unavailable (please refer to
Appendix G for detailed information)
Ward Clerks will be expected to keep a manual record of patients who have been
either admitted, transferred or discharged, this process can be maintained for up
to 24 hours for elective patients being admitted as they will be known to the
Ward. Appendix E for patients being admitted (note that the greyed out areas do
not need to be collected). Appendix F for patients being transferred or
discharged.. Once 24 hours has been exceeded then only emergency patients
will be admitted to the hospital and a manual record kept until PAS is available
again, using the form at Appendix E.
A team of staff are to be identified to input the inpatient data retrospectively once
PAS is available again. It is important that the chronology of patient activity and
movement through the hospital is maintained when completing this work.
For emergency patients being admitted the only method of retrieving patient
records is a phone call to the Health Records Libraries to see if they are on file. If
they are not on file and Maxims is still operational then it will be possible to
access existing patient’s correspondence from previous consultations, this will
not be possible for new patients as Maxims is fed by PAS details.
Wristbands will not be able to be printed whilst PAS is unavailable, therefore
they will need to be handwritten. Special security ink chemical eradication
resistant pens should be available and attached to the wristband printers and are
specifically for the use of writing on wristbands, these are permanent ink pens
and will ensure that information is not able to be removed from the wristbands. It
is Ward Manager’s responsibility to ensure the pens are available. These pens
can be ordered through EROS (WYA1026 - PEN BALLPOINT MEDIUM CRISTAL
DESIGN WITH SECURITY INK CHEMICAL ERADICATION RESISTANT WITH
VENTILATED CAP COMPLIES WITH BS7272 BLACK BIC 125278 NHS SUPPLY
CHAIN BOX 50). In the event of these pens not being available other permanent
ink pens may be used. If ordinary ink pens are used the Ward will need to be
aware and record the risk of information being able to be removed (for example
when patients shower/bath, water may remove/smudge their information).
Telephone enquiries can be dealt with in the usual manner for patients known to
the Ward. If the patient is not known to the Ward and the time has exceeded 24
hours then redirect the caller to the ED department.
6.5
Booked Elective Admissions
All specialty areas to refer to local procedures, which may include (but not
restricted to):
 Weekly download of waiting list in paper format providing list management
during short term unavailability
 TCIs are recorded manually in paper diary or spreadsheets
 PTL printed each week to work from – saved to shared drive
6 Patient Administration System
Business Continuity Plan
All information to be entered retrospectively once PAS is available
6.5
Information Services
A separate Business Continuity Plan exists for the Information Services
Department and can be found at Appendix H
6.6
Other Information Systems that are reliant upon PAS for patient demographics
There are a number of electronic patient record systems that are reliant upon
PAS to feed them with the patient demographic information and identifiers, such
as (but not restricted to):
 Stork Maternity System
 Bluespier Orthopaedic System
 Maxims
 Oceano
These systems will continue to operate for those patients that are already
registered at the point of PAS being unavailable. Any new patients not known to
the individual systems must be managed in accordance with their own Business
Continuity Plans.
7 Patient Administration System
Business Continuity Plan
7. Action Sheet
BUSINESS CONTINUITY ACTION SHEET
(a)
Disruption Category
Service/Business Interruption
(b)
Disruptive Event
Loss of the Patient Administration System
(c)
Risk Rating (Refer to RiskMatrix)
(d)
Description of Nature /
Extent of Impact of this
Event on Service
Likelihood (13
5):
Impact (1-5): 3
Overall Risk-Rating: High
There are planned down times for system enhancements which normally only occur monthly and for short periods
of time – these are planned for and processes are in place to capture and retrospectively enter data once the
system is back up and running again.
The impact upon delivering patient care can vary from insignificant if it is not available for up to 1 hour but once
past this it becomes more critical as each hour passes. Patients cannot be admitted, transferred or discharged
nor can patient records be located and all other systems that interface with PAS will not function either.
Immediate Actions (0-2 Hours):
(e)
#
Description of Necessary Action (and, if appropriate, the
reason it’s necessary)
By Whom
Contact IT helpdesk and put relevant message on helpdesk
answering service
Records Services &
PAS Manager
Senior back office
person
1.
8 Patient Administration System
Business Continuity Plan
Using (staff, resources,
etc.)
Inter-dependencies
2.
Contact appropriate staff in the following areas to begin manual
recording of information:
 Operational Health Records Manager
 Outpatient Waiting List Manager
 Admin Lead for Emergency Medicine
 Access Manager
 Clinical Administrative Leads (Medical Secretaries)
 Ward Managers (Ward Clerks)
 Other Information Asset Owners
 PAS Manager for Peninsula Community Health
Records Services &
PAS Manager (IAO)
3.
All calls for urgent records will initially be made to the Health
Records Library to see if they are on file. This is dependent upon
Maxims still being available to search for the patient and locate
the hospital number
4.
Inform all staff in the organisation not to move any records from
their current location unless it is absolutely essential, and then
only if they have notified the Health Records Library so that they
can record the tracer movement.
Records Services &
PAS Manager
Local procedures to be implemented
All appropriate staff
5.
Subsequent Actions (2-6 Hours):
(f)
#
Description of Necessary Action (and, if appropriate, the
reason it’s necessary)
1.
Update Helpdesk phone message with current situation
Senior back office
person
2.
Continue with manual data collection
All appropriate staff
By Whom
9 Patient Administration System
Business Continuity Plan
Using (staff, resources,
etc.)
Inter-dependencies
3.
Calls for urgent records continue to be made to the Health
Records Library to see if they are on file. This is dependent upon
Maxims still being available to search for the patient and locate
the hospital number
4.
Continue to remind all staff in the organisation not to move any
records from their current location unless it is absolutely
essential, and then only if they have notified the Health Records
Library so that they can record the tracer movement.
Records Services &
PAS Manager
Sustained Actions: (6-24 Hours):
(g)
#
Description of Necessary Action (and, if appropriate, the
reason it’s necessary)
1.
Update telephone message
Senior back office
person
2.
Keep other senior managers informed re situation
Records Services &
PAS Manager
3.
Continue with manual data collection
All appropriate staff
4.
Calls for urgent records continue to be made to the Health
Records Library to see if they are on file. This is dependent upon
Maxims still being available to search for the patient and locate
the hospital number
5.
Inform all staff in the organisation not to move any records from
their current location unless it is absolutely essential, and then
only if they have notified the Health Records Library so that they
can record the tracer movement.
10 Patient Administration System
Business Continuity Plan
By Whom
Records Services &
PAS Manager
Using (staff, resources,
etc.)
Inter-dependencies
6.
Consider using external media to cancel elective patient activity
as records will not be available and the organisation will not know
who has been booked to come in as an inpatient or outpatient
EMT
Long-Term Actions: (1-7 Days+):
(h)
#
1.
Description of Necessary Action (and, if appropriate, the
reason it’s necessary)
By Whom
Continue to remind patients via external media not to come to
hospital for elective activity as records will not be available and
the organisation will not know who has been booked to come in
as an inpatient or outpatient
EMT
2.
Update telephone message
Senior back office
person
3.
Keep other senior managers informed re situation
Records Services &
PAS Manager
4.
Calls for urgent records continue to be made to the Health
Records Library to see if they are on file. This is dependent upon
Maxims still being available to search for the patient and locate
the hospital number
5.
Continue with manual data collection
All appropriate staff
6.
Inform all staff in the organisation not to move any records from
their current location unless it is absolutely essential, and then
only if they have notified the Health Records Library so that they
can record the tracer movement.
Records Services &
PAS Manager
11 Patient Administration System
Business Continuity Plan
Using (staff, resources,
etc.)
Inter-dependencies
7. Informing Staff
7.1. It is essential that all staff are informed of the situation, preferably prior to them arriving for work and is the responsibility of the IAO
to advise staff of alternative instructions.
7.2.
IAO to contact IT manager responsible for Patient Administration System support
7.3
Staff are asked to be flexible during any untoward event and cross cover by staff into other job roles may be necessary to ensure that
Department and Wards can function effectively and efficiently as soon as is practicable.
8. Backup Tape
8.1. Fundamental to the continued viability of the Patient Administration System is the CITS managed back up process.
8.2.
All backup procedures are administered by the Cornwall IT Service.
9
Back Up Facilities
PAS is stored on the Server Farm and in the event of a server failure, data can be transferred to another server within the server
farm.
12 Patient Administration System
Business Continuity Plan
Appendix A
DATE
Patient Records Sent/Filed Without Tracering Due to Unavailability of PAS
CR
SURNAME
FORENAME
NUMBER
Hospital/Dept/Username/Comment/Filed
13 Patient Administration System
Business Continuity Plan
LOCATION OF PATIENT RECORDS
Appendix B
Date
Outpatient Booking Manual Record of Telephone Calls
Name of Patient
NHS Number
Date of Birth
or CR Number
14 Patient Administration System
Business Continuity Plan
Contact
Telephone
Number
Caller enquiry
Appendix C
Reception Manual Data Capture
Date:
Clinic Code
Reception/
Speciality
Patient Name
NHS Number
or CR Number
15 Patient Administration System
Business Continuity Plan
Date of Birth
Attended/
DNA
Additional Comments
Appendix D
Private Patient Data Capture
Date:
Patient Name
NHS Number
or CR Number
Date of Birth
Procedure
Insured or
Required
Self-Pay
16 Patient Administration System
Business Continuity Plan
Contact
Additional Comments
Telephone
Number
Appendix E
Patient admission details
REGISTRATION DETAILS
NHS Number (if known)
Title
Surname
Previous Surname
Forenames/Aliases
Date of Birth
Sex
Male / Female
Transgender
Yes / No
Mr/Mrs/Miss/Ms/Other
Heterosexual / Gay /
Lesbian / Bi-sexual
Sexual Orientation
Occupation
Is your main
language English?
Birthplace
If your main language is
not English what is your
main language?
Do you require an
interpreter/assistance
when you attend
hospital?
Yes / No
Yes / No
Do you have any
known allergies –
please list
Address including
postcode
Home Telephone number
Mobile Telephone
number
Email Address
Do you wish to receive
copies of letters about
you?
Yes / No
Work Telephone
number
Consent to text
messages
Who does this email
address belong to?
Do you wish to
receive copies of
letters by email or
post?
Yes / No
Patient / Carer / Other
Email / Postal Service
If attending school, school address
including postcode and telephone number
General Practitioner –
Name, address and
postcode
Have you ever attended a hospital in
Cornwall before? Please give details of date
and consultant if known.
Religion (please state)
Ethnicity – Please circle
Do you live outside
of the UK for more
Yes / No
than 6 months of the
year?
Asian-Asian British Indian
Asian-Asian British
White British
White Irish
Pakistan
Any other White Background
Background
Mixed White & Black Caribbean
Bangladesh
17 Patient Administration System
Business Continuity Plan
Any Other Asian
Asian-Asian British
REGISTRATION DETAILS
Mixed White & Black African
Caribbean
Mixed White & Asian
Any Other Mixed Background
Any Other Black Background
Patient Declined
Unknown
Black-Black British
Black-Black African
Chinese
Cornish
Patient too unwell
Any other ethnic group not stated:
Next of kin - Name
Relationship
Next of kin address
including postcode
Mobile telephone
number
Home telephone number
Do you consider yourself
to have one of the
disabilities listed (please
circle as many that
apply)
Hearing Impairment
Speech Impairment
Mobility Impairment
Learning Disability
Visual Impairment
Cognitive Impairment
We use and share your information to ensure that we work effectively
with all healthcare professionals in providing a good basis for all health
decisions made about your treatment. We may also use your and share
your information to manage the health service, protect the health of the
general public and staff, investigate concerns or complaints you or your
family have about your healthcare and also for teaching and research
purposes.
Consent to share your
information
The Care Record Guarantee Information Leaflet will explain this in more
detail for you.
You retain the right to withdraw your consent at any time, but we would
recommend that you speak to a healthcare professional to understand
the implications of this decision.
I consent to the Royal Cornwall Hospital NHS Trust in sharing my
information, providing that this is compliant with the Data Protection Act
1998 and the common law duty of confidentiality.
Signed:
Printed name if not patient signing:
Relationship to patient if not patient signing:
Date:
18 Patient Administration System
Business Continuity Plan
Appendix F
Patient transfer or discharge
Ward:
Patient Name
NHS/CR Number
Hospital and ward
transferred to or
destination on discharge
19 Patient Administration System
Business Continuity Plan
Consultant transferred
to
Date of
transfer/discharge
Appendix G
BUSINESS CONTINUITY PROCEDURES IN THE
EVENT OF SWIFTPLUS FAILURE
Release:
Final
Date:
September 2011
PRINCE2
Author:
Shelley Thorpe, Operational Project Manager
Owner:
Client:
RCHT
Document Ref:
BC Procedures In the Event of SWiftPlus
Failure.doc
Version No:
Final
20 Patient Administration System
Business Continuity Plan
Project Quality Plan History
Document Location
This document replaces all previously dated versions and is only valid on the day it was
printed. The source of the document will be found on the project's folder in Tcs_Data 15/0251
SWiftPlus/Business Continuity/BCprocedures In the event of a SWiftPlus Failure
Electronic copies of this document are stored in the following locations:

Intranet document library
Updated paper copies of this document are to be stored in the following locations:

Site Co-ordination Office
21 Patient Administration System
Business Continuity Plan
Contents
PATIENT ADMINISTRATION SYSTEM ................................................................................. 1 7. Action Sheet ...................................................................................................................... 8 Occupation .......................................................................................................................... 17 Birthplace ............................................................................................................................ 17 Yes / No ............................................................................................................................ 17 Yes / No ............................................................................................................................ 17 Email / Postal Service ..................................................................................................... 17 Yes / No ............................................................................................................................ 17 Project Quality Plan History .................................................................................................. 21 Document Location ........................................................................................................... 21 Contents................................................................................................................................ 22 Aims and Objectives of the Procedures ................................................................................ 25 Aim .................................................................................................................................... 25 Objectives ......................................................................................................................... 25 Initiation of Business Continuity Process .............................................................................. 25 Identification of a Business Continuity Event .................................................................... 25 Key Stakeholders .............................................................................................................. 25 Establishing Roles and Responsibilities............................................................................ 26 Cornwall IT Services Role ................................................................................................. 26 Business Continuity Checklist ........................................................................................... 27 Out of Hours Arrangements .............................................................................................. 29 Fall Back Arrangements .................................................................................................... 29 Web Server Failure ............................................................................................................... 30 Objective ........................................................................................................................... 30 Overview ........................................................................................................................... 30 Resources Required ......................................................................................................... 30 Procedure for Web server failure ...................................................................................... 30 22 Patient Administration System
Business Continuity Plan
Procedure when Web server is back up ........................................................................... 30 Whiteboard Failure................................................................................................................ 31 Objective ........................................................................................................................... 31 Overview ........................................................................................................................... 31 Procedure for reporting whiteboard failure ........................................................................ 31 Procedure when PC is back up ......................................................................................... 31 PC / COW Failure ................................................................................................................. 32 Objective ........................................................................................................................... 32 Overview ........................................................................................................................... 32 Procedure for reporting workstation failure ....................................................................... 32 Procedure when PC is back up ......................................................................................... 32 Network / Power Failure ........................................................................................................ 33 Objective ........................................................................................................................... 33 Overview ........................................................................................................................... 33 Resources required ........................................................................................................... 33 Procedure for Network / Power failure .............................................................................. 33 Procedure when Network / Power is restored ................................................................... 34 PAS - SWiftPlus Messaging Failure ...................................................................................... 35 Objective ........................................................................................................................... 35 Overview ........................................................................................................................... 35 Resources required ........................................................................................................... 35 Procedure for PAS/SWiftPlus Message failure ................................................................. 35 Procedure when PAS/SWiftPlus Messaging restored....................................................... 35 PAS Failure ........................................................................................................................... 37 Objective ........................................................................................................................... 37 Overview ........................................................................................................................... 37 Procedure for PAS ............................................................................................................ 37 Procedure when PAS is restored ...................................................................................... 37 23 Patient Administration System
Business Continuity Plan
PAS Connectivity Failure ...................................................................................................... 39 Objective ........................................................................................................................... 39 Overview ........................................................................................................................... 39 Procedure for PAS connectivity failure.............................................................................. 39 Procedure when PAS Connectivity is restored ................................................................. 39 Contents................................................................................................................................ 41 PAS BUSINESS CONTINUITY PLAN: Information Services Sections ................................. 42 1. Outpatients .................................................................................................................... 42 2. Inpatients: ..................................................................................................................... 42 3. Waiting Lists: ................................................................................................................. 42 4. Theatres (GALAXY): ..................................................................................................... 43 5. ICS (Integrated Care System): ...................................................................................... 43 6. STORK (Maternity)........................................................................................................ 43 Version Control Table ..................................................................................................... 45 24 Patient Administration System
Business Continuity Plan
Aims and Objectives of the Procedures
Aim
This procedural document has been designed to prepare Royal Cornwall Hospitals NHS
Trust to cope with the effects of SWiftPlus systems failure. It is intended that this document
will provide the basis for a relatively quick and painless return to ‘Business as Usual’
regardless of the cause.
Objectives

Understand the critical functions and activities of SWiftPlus within the organisation;

Analyse and respond to the risks for the organisation;

Provide a detailed prioritised and timetabled response to a SWiftPlus system/s failure
situation;

Identify the key roles, responsibilities and contacts to respond to SWiftPlus system/s
failure.
Initiation of Business Continuity Process
This document may be used as a checklist to ensure that critical tasks are completed
according to a pre-agreed priority schedule.
Identification of a Business Continuity Event
A SWiftPlus systems failure will normally be identified in one of two ways:

Detected by the ward staff or Site Co-ordination Team, through whiteboard
monitoring;

Detected operationally, through usage of the system or process failure.
Key Stakeholders
Where any such SWiftPlus systems failure is identified, the following individuals should be
alerted by e-mail; telephone; and Net Page Message.
25 Patient Administration System
Business Continuity Plan
Role
Name
Net Page/Email/Tel No
Duty Engineer
Telephone via switch
Ward Managers
Shift Leaders
Site Co-ordination Team
IT Duty Engineer
Establishing Roles and Responsibilities
At the point of a SWiftPlus Application Systems failure, a Business Continuity Event Lead
will be agreed by the business and will co-ordinate and initiate the Business Continuity
Procedures liaising with CITS.
Cornwall IT Services Role
Cornwall IT Services (CITS) will provide assistance in all system failure incidents within this
Business Continuity Plan. Their role is to support the Trust in order to bring the systems
back to normal working mode as fast as possible.
CITS will provide the following:

Call management service via ext 1717

Escalation and liaison with Third Party Suppliers

All user email communications

Progress reports to the Business Continuity Event Lead

Emergency service out of hours via ext 1717.
The CITS service has been accredited by Connecting for Health and will implement the
“Incident Management Process” and “Problem Management Process” in order to resolve any
issues.
26 Patient Administration System
Business Continuity Plan
Business Continuity Checklist
This checklist should be used by the Business Continuity Event Lead during the SWiftPlus
system/s failure.
Completed
Date/Time/By
Task
Potential SWiftPlus Systems failure identified
SWiftPlus System Failure Confirmed (and not user error)
Business Continuity Event Lead agreed (Operational)
Identify SWiftPlus Systems Failure Type

Web server Failure (refer to page 9)

Electronic Whiteboard Failure (refer to page 10)

PC Failure (refer to page11)

Network/Power (refer to page 12)

PAS SWiftPlus Messaging Failure (refer to page 13)

PAS Failure (refer to page 14)

PAS Connectivity Failure (refer to page 15)
Initiate Immediate Communication to Users (Wards and Customers):
27 Patient Administration System
Business Continuity Plan

Ward Manager/Shift Leader

Hospital Duty Manager (switch telephone)

Ward Staff (face to face/telephone/email)

Site Co-Ordination Team (face to face/telephone/email)
The content/type of communication will depend upon the system/s affected and
action/s required.
Initiate appropriate Business Continuity Event Type Actions
Convene Business Recovery Planning with the following stakeholders
as necessary:

Duty Hospital Manager

IT Service Lead

Sit Co-Ordination Team

Ward Manager/Shift Leader
Confirm Business Recovery Plan timescales and approach
Maintain Business Communication and implement Business Recovery Plan

Ward Manager/Shift Leader

Hospital Duty Manager (switch telephone)

Ward Staff (face to face/telephone/email)
28 Patient Administration System
Business Continuity Plan

Site Co-Ordination Team (face to face/telephone/email)
Carry out review, follow up and escalation as necessary through Ward
Manager/Shift Leader
Out of Hours Arrangements
Out of hours business continuity is to be handled locally by Shift Leader/Ward Manager.
Escalation to be established by Business Continuity Event Lead to On Call Engineer via
switchboard for appropriate escalation when office hours are resumed or for emergency,
immediate escalation where necessary (as defined by Business Continuity Event Lead).
Fall Back Arrangements
The Key Stakeholders will decide upon the time and procedure of fallback for any of the
given SwiftPlus system failure scenarios:
Role
Name
Net Page/Email/Tel No
IT Service Manager
Rachel Bennetts
[email protected]/1717
IT Duty Engineer
Duty Engineer
Telephone via switch
Ward Manager
29 Patient Administration System
Business Continuity Plan
Web Server Failure
Objective
To maintain clinical operations when there is a web server failure.
Overview
In the event of a web server failure:

SWiftPlus bed states will not be up to date/visible via the Ward Whiteboard

SWiftPlus bed states will not be visible via pc’s or COWS
Resources Required

PAS (CORE)
Procedure for Web server failure
ACTION
RESPONSIBLE
1.
Check whether there is access via another pc/whiteboard or user
logged in.
Users
2.
Arrange to view bed state via PAS (CORE) print bed state if
necessary.
Users
Procedure when Web server is back up
ACTION
1.
RESPONSIBLE
Refresh whiteboard or Log back into whiteboard
30 Patient Administration System
Business Continuity Plan
Users
Whiteboard Failure
Objective
To maintain clinical operations when there is a PC failure.
Overview
In the event of a Whiteboard failure:

Bed State may not be visible on whiteboard

Assume that issue is localised to one Whiteboard
Procedure for reporting whiteboard failure
ACTION
RESPONSIBLE
1.
Check whether there is access via PC in immediate vicinity and
use this, reporting a fault on first whiteboard
Users
2.
Check whether there is access via another PC in another area
Users
3.
Print bed state from SWiftPlus or PAS as necessary
Assigned by Business
Continuity Event Lead
4.
Install contingency whiteboard or temporarily move whiteboard
from area where whiteboard is not in use.
Assigned by Business
Continuity Event Lead
Procedure when PC is back up
ACTION
1.
RESPONSIBLE
Use as normal
Users
31 Patient Administration System
Business Continuity Plan
PC / COW Failure
Objective
To maintain clinical operations when there is a PC failure.
Overview
In the event of a PC/COW failure:

SWiftPlus will not be accessible;

Assumed that issue is localised to one PC.
Procedure for reporting workstation failure
ACTION
RESPONSIBLE
1.
Check whether there is access via PC/COW in immediate vicinity
and use this one, reporting a fault on first pc/COW
Users
2.
Check whether there is access via another PC in another area
Users
Procedure when PC is back up
ACTION
1.
RESPONSIBLE
Use as normal
Users
32 Patient Administration System
Business Continuity Plan
Network / Power Failure
A network failure could include any, or all of the following:

Switch failure to whiteboards PC’s or COWS;

Power failure to switches or key areas;

Wide area network faults.
Objective
To maintain clinical operations when there is a network or power failure, and perform data
recovery when these come back on line.
Overview
In the event of a network or power failure:

SWiftPlus and PAS will not be available

Assumed some areas are not affected and able to function as normal.
Resources required
Procedure for Network / Power failure
ACTION
1.
RESPONSIBLE
Use alternative facilities if available on site
Users
Assigned by Business
Continuity Event Lead
2.
Consider using alternative facilities off-site
Users
Assigned by Business
Continuity Event Lead
5.
Keep a manual list of patient moves
Assigned by Business
33 Patient Administration System
Business Continuity Plan
Continuity Event Lead
Procedure when Network / Power is restored
ACTION
1.
RESPONSIBLE
Record attendances on SWiftPlus/PAS
Users
Assigned by Business
Continuity Event Lead
34 Patient Administration System
Business Continuity Plan
PAS - SWiftPlus Messaging Failure
A PAS – SWiftPlus Messaging failure could include any, of the following:

Slow network speed;

Wide area network faults;
Objective
To maintain clinical operations when there is a PAS - SWiftPlus Messaging failure by
performing housekeeping and data recovery when these become fully functional.
Overview
In the event of a PAS/SWiftPlus Messaging failure:

Bed States may not/may not all be sent from SWiftPlus to PAS;

Bed States may not/may not all be received by SWiftPlus from PAS;

User Defined Items will be available and updatable.
Resources required

Pen and Paper
Procedure for PAS/SWiftPlus Message failure
ACTION
1.
RESPONSIBLE
Update SwiftPlus
Assigned by Business
Continuity Event Lead
Procedure when PAS/SWiftPlus Messaging restored
ACTION
RESPONSIBLE
35 Patient Administration System
Business Continuity Plan
1.
Updates should automatically flow through to PAS.
Investigate any unprocessed updates.
36 Patient Administration System
Business Continuity Plan
Assigned by Business
Continuity Event Lead
PAS Failure
Objective
To maintain clinical operations when there is PAS failure and perform data recovery when
the systems come back on line.
Overview
In the event of a PAS failure:

Users will be unable to register new patients;

Users will not be able to update patient demographics;

Users will not be able to merge patients;

(In) Patient location will not be up to date
Procedure for PAS
ACTION
1.
RESPONSIBLE
All user email
CITS Service Desk
Assigned by Business
Continuity Event Lead
2.
Requests against unregistered patients require a paper request
using Examination/Specimen Order Request back-Up form
Requestor/Clinician
3
Keep log of patient moves
Ward Staff
Assigned by Business
Continuity Event Lead
Procedure when PAS is restored
ACTION
RESPONSIBLE
37 Patient Administration System
Business Continuity Plan
1.
Record all patient moved on SWiftPlus or PAS
Ward Staff
Assigned by Business
Continuity Event Lead
38 Patient Administration System
Business Continuity Plan
PAS Connectivity Failure
Objective
To maintain clinical operations when there is PAS connectivity failure and perform data
recovery when the systems come back on line.
Overview
In the event of a PAS connectivity failure:

New registrations will not be available on SWiftPlus;

Updates to patient demographics will not be available within SWiftPlus;

Any merge operations being carried out will not be fulfilled.

(In) Patient location may not be up to date
Procedure for PAS connectivity failure
ACTION
1.
RESPONSIBLE
All user email
CITS Service Desk
Assigned by Business
Continuity Event Lead
2.
Manual list of unregistered patients
User
Procedure when PAS Connectivity is restored
ACTION
RESPONSIBLE
Register patients/update demographics on PAS
39 Patient Administration System
Business Continuity Plan
Assigned by Business
Continuity Event Lead
Appendix H
Information/Reporting
PAS Business Continuity Plan Information/Reporting Perspective
Information Services Department
40 Patient Administration System
Business Continuity Plan
Contents
PATIENT ADMINISTRATION SYSTEM ................................................................................. 1 7. Action Sheet ...................................................................................................................... 8 Occupation .......................................................................................................................... 17 Birthplace ............................................................................................................................ 17 Yes / No ............................................................................................................................ 17 Yes / No ............................................................................................................................ 17 Email / Postal Service ..................................................................................................... 17 Yes / No ............................................................................................................................ 17 Project Quality Plan History .................................................................................................. 21 Document Location ........................................................................................................... 21 Contents................................................................................................................................ 22 Aims and Objectives of the Procedures ................................................................................ 25 Aim .................................................................................................................................... 25 Objectives ......................................................................................................................... 25 Initiation of Business Continuity Process .............................................................................. 25 Identification of a Business Continuity Event .................................................................... 25 Key Stakeholders .............................................................................................................. 25 Establishing Roles and Responsibilities............................................................................ 26 Cornwall IT Services Role ................................................................................................. 26 Business Continuity Checklist ........................................................................................... 27 Out of Hours Arrangements .............................................................................................. 29 Fall Back Arrangements .................................................................................................... 29 Web Server Failure ............................................................................................................... 30 Objective ........................................................................................................................... 30 Overview ........................................................................................................................... 30 41 Patient Administration System
Business Continuity Plan
Resources Required ......................................................................................................... 30 Procedure for Web server failure ...................................................................................... 30 Procedure when Web server is back up ........................................................................... 30 Whiteboard Failure................................................................................................................ 31 Objective ........................................................................................................................... 31 Overview ........................................................................................................................... 31 Procedure for reporting whiteboard failure ........................................................................ 31 Procedure when PC is back up ......................................................................................... 31 PC / COW Failure ................................................................................................................. 32 Objective ........................................................................................................................... 32 Overview ........................................................................................................................... 32 Procedure for reporting workstation failure ....................................................................... 32 Procedure when PC is back up ......................................................................................... 32 Network / Power Failure ........................................................................................................ 33 Objective ........................................................................................................................... 33 Overview ........................................................................................................................... 33 Resources required ........................................................................................................... 33 Procedure for Network / Power failure .............................................................................. 33 Procedure when Network / Power is restored ................................................................... 34 PAS - SWiftPlus Messaging Failure ...................................................................................... 35 Objective ........................................................................................................................... 35 Overview ........................................................................................................................... 35 Resources required ........................................................................................................... 35 Procedure for PAS/SWiftPlus Message failure ................................................................. 35 Procedure when PAS/SWiftPlus Messaging restored....................................................... 35 PAS Failure ........................................................................................................................... 37 Objective ........................................................................................................................... 37 Overview ........................................................................................................................... 37 42 Patient Administration System
Business Continuity Plan
Procedure for PAS ............................................................................................................ 37 Procedure when PAS is restored ...................................................................................... 37 PAS Connectivity Failure ...................................................................................................... 39 Objective ........................................................................................................................... 39 Overview ........................................................................................................................... 39 Procedure for PAS connectivity failure.............................................................................. 39 Procedure when PAS Connectivity is restored ................................................................. 39 Contents................................................................................................................................ 41 PAS BUSINESS CONTINUITY PLAN: Information Services Sections ................................. 44 1. Outpatients .................................................................................................................... 44 2. Inpatients: ..................................................................................................................... 44 3. Waiting Lists: ................................................................................................................. 44 4. Theatres (GALAXY): ..................................................................................................... 45 5. ICS (Integrated Care System): ...................................................................................... 45 6. STORK (Maternity)........................................................................................................ 45 Version Control Table ..................................................................................................... 47 43 Patient Administration System
Business Continuity Plan
PAS BUSINESS CONTINUITY PLAN: Information Services
Sections
1. Outpatients
In the event of a major PAS downtime, the most recent Outpatient Waiting Lists (OPWL) can
be used to as a Clinic attendance list and will enable Outpatient staff to check the number of
patients expected to arrive to each Clinic.
As well as booked appointments the OPWL includes information downloaded from the
Pending List. This information can be used to track the patients who are still in need of an
appointment.
Information Services download Outpatient Waiting Lists (OPWL) on a weekly basis, every
Saturday. This information is available in several different places to ensure that backup
information exists. The primary locations are: Cognos available via the Intranet, the Waiting
List Evaluation file and the RTT Booking tool both available on the Shared Drive (Data 11).
The data is also available on the Information Services Server (EIS_03) and the EIS SQL
Server on the SAN (EIS_SQL).
2. Inpatients:
In the event of a major PAS downtime Information Services provide several datasets which
could be used to help to understand the current inpatient situation across the Trust.
Current Inpatients: On a daily basis Information Services pull a list from PAS of the patients
who are currently listed on PAS on every ward on each site. The most recent dataset can be
used to assess how many patients are on site as Inpatients and where they are located.
This information is available in several different places to ensure that backup information
exists. The primary location is: Cognos available via the Intranet, the data is also available
on the Information Services Server (EIS03) and could be made available from the CACI data
warehouse.
Expected admissions: Information Services download Inpatient Waiting Lists (IPWL) on a
twice weekly basis; every Friday and Wednesday. This information is available in several
different places to ensure that backup information exists. The primary locations are: Cognos
available via the Intranet, the Waiting List Evaluation file, the RTT Booking tool both
available on the Shared Drive (Data 11). The data is also available on the Information
Services Server (EIS_03) and the EIS SQL Server on the SAN (EIS_SQL).
3. Waiting Lists:
In the event of a major PAS downtime Information Services provide several datasets which
could be used to help to understand the current waiting list situation across the Trust.
Waiting list downloads are taken from PAS on the following basis:
44 Patient Administration System
Business Continuity Plan
Inpatients: Information Services download Inpatient Waiting Lists (IPWL) on a twice-weekly
basis; every Friday and Wednesday. The reports list patients with and without TCI (to come
in) dates. This information is available in several different places to ensure that backup
information exists. The primary locations are: Cognos available via the Intranet, the Waiting
List Evaluation file, the RTT Booking tool. The data is also available on the Information
Services Server.
Outpatients: Information Services download Outpatient Waiting Lists (OPWL) on a weekly
basis; every Saturday. The reports list patients with and without appointment dates. This
information is available in several different places to ensure that backup information exists.
The primary locations are: Cognos available via the Intranet, the Waiting List Evaluation file,
the RTT Booking tool. The data is also available on the Information Services Server.
4. Theatres (GALAXY):
The Trust’s Theatre data is recorded on the Galaxy system and is therefore not part of the PAS Business Continuity Plan.
5. ICS (Integrated Care System):
Believe that this system is not used to record RCHT activity.
6. STORK (Maternity)
Information Services download data from the Maternity system on a daily basis. In the event
that the STORK system went down for any length of time Information Services would be able
to provide data up to the day prior to the day the system went down. This data would relate
to Patients who have delivered their baby. The primary locations are: Cognos available via
the Intranet, the information services server and the CACI data warehouse.
In addition we pull data out of the system on a monthly basis for all patients who have been
‘booked’ in the previous month. These reports could be used to ascertain patients expected
to deliver. These reports are available on the information services server and are sent out to
the Maternity staff routinely.
45 Patient Administration System
Business Continuity Plan
Appendix I. Governance Information
Document Title
Patient Administration System Business
Continuity Plan
Date Issued/Approved:
6 Jun 12
Date Valid From:
6 Jun 12
Date Valid To:
6 Jun 15
Directorate / Department responsible
(author/owner):
Kim Bellis,
Records Services and PAS Manager
Contact details:
01872 254500
Failure to deliver the Trust wide Patient
Administration System could have a
detrimental effect on patient care and patient
safety. This plan describes the
arrangements needed to recover from a
system failure and maintain services that
rely on PAS availability.
Patient Administration, Business Continuity,
Disaster Recovery, System Failure.
RCHT
PCT
CFT

Brief summary of contents
Suggested Keywords:
Target Audience
Executive Director responsible for
Policy:
Director of Finance
Date revised:
New Document
This document replaces (exact title of
previous version):
New Document
Approval route (names of
committees)/consultation:
HI&ICT
Divisional Manager confirming
approval processes
Simon Goodwin, Head of HI&ICT
Name and Post Title of additional
signatories
Not Required
Signature of Executive Director giving
approval
Publication Location (refer to Policy
on Policies – Approvals and
Ratification):
Internet & Intranet
Health Informatics /
Document Library Folder/Sub Folder
46 Patient Administration System
Business Continuity Plan
{Original Copy Signed}
 Intranet Only
Infrastructure/Technical/Security
Links to key external standards
None
Related Documents:
None
Training Need Identified?
No
Version Control Table
Version
Summary of Changes
No
04.01.2012 V1
First issue
Date
28.02.2012 V1.1
Second issue to include comments from
PAS users
17.05.2012 V1.2
Includes detail on special pens needed to
write on wristbands
Changes Made by
(Name and Job Title)
Kim Bellis
Records Services &
PAS Manager
Kim Bellis
Records Services &
PAS Manager
Kim Bellis
Records Services, PAS
& Data Quality
Manager
Acknowledgement to Paul Sylvester and those involved in the work previously
carried out on a draft Business Continuity Plan for the Patient Administration System
All or part of this document can be released under the Freedom of
Information Act 2000
This document is to be retained for 10 years from the date of expiry.
This document is only valid on the day of printing
Controlled Document
This document has been created following the Royal Cornwall Hospitals NHS
Trust Policy on Document Production. It should not be altered in any way
without the express permission of the author or their Line Manager.
47 Patient Administration System
Business Continuity Plan